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I83.204 ICD-10-CM Code: Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation

Compare with another code for I83.204Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Use additional codefrom I83.2Report with this code when documented
  • Use additional code to identify severity of ulcer (L97.-)
Excludes2from I83Not included here; may be reported together
  • varicose veins complicating pregnancy (O22.0-)
  • varicose veins complicating the puerperium (O87.4)
IncludesWhat this code covers
  • Varicose veins of unspecified lower extremity with both ulcer of plantar surface of midfoot and inflammation

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 299 — PERIPHERAL VASCULAR DISORDERS WITH MCC (MDC 05)
  • MS-DRG 300 — PERIPHERAL VASCULAR DISORDERS WITH CC (MDC 05)
  • MS-DRG 301 — PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC (MDC 05)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle

Other models: CMS-HCC V22 HCC 107

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for I83.204 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on I83.204 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Varicose veins of unspecified lower extremity with both ulcer of plantar surface of midfoot and inflammation

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from I83

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify severity of ulcer (L97.-)

Source: inherited from I83.2

Coder workflow for I83.204

MedCoder structured workflow — derived from this code’s own official record

Before you code I83.204

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, I83.204 may be the appropriate code. No code beside it in this subcategory is more specific; when the record documents what the title leaves unspecified, look the documented term up in the Alphabetic Index, which may lead to a code outside this subcategory. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18, I.B.1).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. I83.204’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Choose the right path

  1. Does the record document the detail this title leaves unspecified?
    Yes → Look the documented term up in the Alphabetic Index; the code it leads to may sit outside this subcategory.
    No → Continue — I83.204 is appropriate when the documentation goes no further.

Consider I83.204. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Anatomical site
At the most specific level the record states; a site the classification separates cannot be assumed from a procedure or a measurement.
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Any detail beyond this code’s title
What the record states that a more specific code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes2 — not part of I83.204(2 notes)

    Coding workflow: The conditions named in this note are not included in I83.204. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareO22.0, O87.4

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying I83.204(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with I83.204 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewL97

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific code supportable?

Path: No sibling in this subcategory is more specific; look the documented detail up in the Alphabetic Index.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is I83.204 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with I83.204?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewL97

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation is a billable ICD-10-CM diagnosis code (I83.204).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • Age-restricted: the Medicare Code Editor lists this as an adult (age 15-124) diagnosis; other ages are presumed incorrect.
  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name I83.204 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: I87.2 — Venous insufficiency (chronic) (peripheral) (via I83.2.-), I87.3 — Chronic venous hypertension (idiopathic) (via I83.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes: L98.4 — Non-pressure chronic ulcer of skin, not elsewhere classified (via I83.-), L98.A — Non-pressure chronic ulcer of upper limb, not elsewhere classified (via I83.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: L97 — Non-pressure chronic ulcer of lower limb, not elsewhere classified (via I83.2.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 49 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 299 (MDC 05), DRG 300 (MDC 05), DRG 301 (MDC 05).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):CIR035 — Varicose veins of lower extremity (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

I83.024 — Varicose veins of left lower extremity with ulcer of heel and midfoot, I83.025 — Varicose veins of left lower extremity with ulcer other part of foot, I83.028 — Varicose veins of left lower extremity with ulcer other part of lower leg, I83.029 — Varicose veins of left lower extremity with ulcer of unspecified site, I83.10 — Varicose veins of unspecified lower extremity with inflammation, I83.11 — Varicose veins of right lower extremity with inflammation, I83.12 — Varicose veins of left lower extremity with inflammation, I83.201 — Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation, I83.202 — Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation, I83.203 — Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation, I83.205 — Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation, I83.208 — Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation, I83.209 — Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation, I83.211 — Varicose veins of right lower extremity with both ulcer of thigh and inflammation, I83.212 — Varicose veins of right lower extremity with both ulcer of calf and inflammation, I83.213 — Varicose veins of right lower extremity with both ulcer of ankle and inflammation, I83.214 — Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation, I83.215 — Varicose veins of right lower extremity with both ulcer other part of foot and inflammation, I83.218 — Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation, I83.219 — Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation, +28 more

Same condition, different side

Same title, differing only in which side of the body it names: right, left, bilateral or unspecified.

I83.214 — Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation (right)Compare I83.204 vs I83.214 →, I83.224 — Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation (left)Compare I83.204 vs I83.224 →

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle) for risk-adjusted payment.

I83.021 — Varicose veins of left lower extremity with ulcer of thigh, I83.022 — Varicose veins of left lower extremity with ulcer of calf, I83.023 — Varicose veins of left lower extremity with ulcer of ankle, I83.024 — Varicose veins of left lower extremity with ulcer of heel and midfoot, I83.025 — Varicose veins of left lower extremity with ulcer other part of foot, I83.028 — Varicose veins of left lower extremity with ulcer other part of lower leg, I83.029 — Varicose veins of left lower extremity with ulcer of unspecified site, I83.201 — Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation, I83.202 — Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation, I83.203 — Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation, I83.205 — Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation, I83.208 — Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation, I83.209 — Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation, I83.211 — Varicose veins of right lower extremity with both ulcer of thigh and inflammation, I83.212 — Varicose veins of right lower extremity with both ulcer of calf and inflammation, I83.213 — Varicose veins of right lower extremity with both ulcer of ankle and inflammation, I83.214 — Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation, I83.215 — Varicose veins of right lower extremity with both ulcer other part of foot and inflammation, I83.218 — Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation, I83.219 — Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation, +287 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Atherosclerosis of Arteries of the Extremities with Ulceration or Gangrene, Pressure Ulcer of Skin with Necrosis Through to Muscle, Tendon, or Bone, Chronic Ulcer of Skin, Except Pressure, Through to Bone or Muscle, Pressure Ulcer of Skin with Full Thickness Skin Loss, Pressure Ulcer of Skin with Partial Thickness Skin Loss

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Varicose veins of lower extremity).

I83.024 — Varicose veins of left lower extremity with ulcer of heel and midfoot, I83.025 — Varicose veins of left lower extremity with ulcer other part of foot, I83.028 — Varicose veins of left lower extremity with ulcer other part of lower leg, I83.029 — Varicose veins of left lower extremity with ulcer of unspecified site, I83.10 — Varicose veins of unspecified lower extremity with inflammation, I83.11 — Varicose veins of right lower extremity with inflammation, I83.12 — Varicose veins of left lower extremity with inflammation, I83.201 — Varicose veins of unspecified lower extremity with both ulcer of thigh and inflammation, I83.202 — Varicose veins of unspecified lower extremity with both ulcer of calf and inflammation, I83.203 — Varicose veins of unspecified lower extremity with both ulcer of ankle and inflammation, I83.205 — Varicose veins of unspecified lower extremity with both ulcer other part of foot and inflammation, I83.208 — Varicose veins of unspecified lower extremity with both ulcer of other part of lower extremity and inflammation, I83.209 — Varicose veins of unspecified lower extremity with both ulcer of unspecified site and inflammation, I83.211 — Varicose veins of right lower extremity with both ulcer of thigh and inflammation, I83.212 — Varicose veins of right lower extremity with both ulcer of calf and inflammation, I83.213 — Varicose veins of right lower extremity with both ulcer of ankle and inflammation, I83.214 — Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation, I83.215 — Varicose veins of right lower extremity with both ulcer other part of foot and inflammation, I83.218 — Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation, I83.219 — Varicose veins of right lower extremity with both ulcer of unspecified site and inflammation, +41 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Varix”; these codes share that main term but sit in a different category of the Tabular List.

H35.09 — Other intraretinal microvascular abnormalities (retina), I77.0 — Arteriovenous fistula, acquired (aneurysmal), I78.1 — Nevus, non-neoplastic (papillary), I85.00 — Esophageal varices without bleeding (esophagus), I85.01 — Esophageal varices with bleeding (esophagus, bleeding), I85.10 — Secondary esophageal varices without bleeding (esophagus, secondary), I85.11 — Secondary esophageal varices with bleeding (esophagus, secondary, bleeding), I86.0 — Sublingual varices (sublingual), I86.1 — Scrotal varices (scrotum), I86.2 — Pelvic varices (ovary), I86.3 — Vulval varices (vulva), I86.4 — Gastric varices (gastric), I86.8 — Varicose veins of other specified sites (orbit), O22.0 — Varicose veins of lower extremity in pregnancy (complicating, pregnancy), O22.1 — Genital varices in pregnancy (complicating, pregnancy, genital), O22.4 — Hemorrhoids in pregnancy (complicating, pregnancy, anus or rectum), O43.89 — Other placental disorders (placenta), O87.2 — Hemorrhoids in the puerperium (complicating, puerperium, anus or rectum), O87.4 — Varicose veins of lower extremity in the puerperium (complicating, childbirth), O87.8 — Other venous complications in the puerperium (complicating, puerperium, genital), +1 more

Contextual Map

Every relationship of I83.204 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run I83.204 with these 5 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 383 — Chronic Ulcer of Skin, Except Pressure, Not Specified as Through to Bone or Muscle [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 05 — Diseases and Disorders of the Circulatory System[MDC crossing]: “Diseases and Disorders of the Circulatory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 15,708 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Varix (lower limb), leg (asymptomatic), with, ulcer, heel, with inflammation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Varix (lower limb), leg (asymptomatic), with, ulcer, midfoot, with inflammation[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "I83.204 — Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/i83.204-varicose-veins-of-unspecified-lower-extremity-with-both-ulcer-of-heel-and-midfoot-and-inflammation

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Varicose veins of unspecified lower extremity with both ulcer of heel and midfoot and inflammation

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I83.204 in its code family, with their registry titles.

View all codes in the I83 family